Pulmonology Coding Alert
Update Doctor's Number, Not Incident-to Coding
Question: Will the new National Provider Identifier (NPI) change how we report services incident-to?
North Carolina Subscriber
Answer: No. The CMS-issued, 10-digit NPI number will replace the current identifiers carriers use, such as the provider identification number (PIN) and the unique provider identification number (UPIN). But the change will not affect your incident-to coding.
You will simply report a service incident-to using a pulmonologist's or nonphysician practitioner's NPI, instead of his current identification number.
Example: An office nurse performs a pulmonary function test for an asthma patient who has a standing order for a PFT check every six months. When your pulmonologist or group obtains their NPIs, you'll report 99211 (Office or other outpatient visit for the evaluation and management of an established patient ...) incident-to the on-duty NPI with the appropriate asthma diagnosis (such as, 786.07, Wheezing).
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